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Working With the Narrative – A Presence Centered Approach

I recently gave an intensive therapy workshop for therapists who are in their postgraduate training. Much of the work moved to a focus on the experience of Presence as it reflected and effected the client’s self-in-life. The work was powerful and moving, and fluidly moved from their immediate experience, to their life context, to something less defined by content and more (defined) by their Being meeting my Being. Since these were therapists who were attending, and they had been in therapy for several years, there were questions regarding how to work with people who were not able to allow their narrative to “fall away” – i.e. who were more fully identified with and unaware of their narratives and identifications. That is, how to work with the average person who walks into gestalt therapy. Clearly, we do not and cannot begin with a focus on the purely emergent, content-less self. So, here are some of my thoughts: People come to therapy, for the most part, because they feel some degree of pain or dissatisfaction, and they feel stuck or unable to change themselves or their life circumstances. For most people, this is not simply because they are not smart enough to “figure it out”, or because their life circumstances are beyond the possibility of change. It is, rather, because they have fixed ways of seeing themselves and their world, and they may not even know about their fixities. The last thing the fish sees is the water, and people are so immersed in their way of seeing that they are not aware of their lenses. These lenses lock them into...

Cliché Layer or The Art of Small Talk

Cliché Layer is by far the most disrespected layer of the neurotic personality. It is so disrespected that Fritz Perls would call it the “chicken shit layer”. And as Gestalt therapists, we tend to turn our collective noses up when it comes to “chit chat”. But, it has recently occurred to me that people who are not conversant with cliche layer interaction are handicapped living in our culture. Many of my patients – even those who I’ve been seeing for years, and who have done deep, moving work with me – come into my office every week asking “how’s everything?” or “how was your week?” or some such question. Usually, I respond by saying “fine”; sometimes I ask if they really want to know, or remark that a week is a lot of time to summarize. But they’re not really asking me how I am – they’re saying hello. And they’re conveying a sense of friendliness and interest in our relationship. Seemingly meaningless communications can convey a sense of good will, while not revealing or requiring much transparency. An ability to engage on that level allows some sense of safety and interest to germinate, and can signal some openness to further contact and communication. Even for those of us who are interested in self-reflection, and in intimate communication, many of our contexts do not support or allow this. Working in a collegial setting, for example, usually does not allow for intimate inquiry or unburdening self-revelation. And yet, if there is only communication about the task at hand, there will likely be an atmosphere of detachment, and a diminished sense...

Polarities

It has long been understood that any value, quality, or attribute exists in relation to its opposite. So, “up” has meaning in relation to “down”, “poor” has meaning in relation to “wealthy”, “dry” has meaning in relation to “wet”, and so on. The ancient symbol of the Yin/Yang visually depicts a “whole” which is composed of the joining of opposites. A healthy (as opposed to “unhealthy”) understanding of polarities accepts the simultaneous existence of both polarities, and the range and complexity of potential that this creates. We may choose to act in a generous or selfless way, knowing that we are also capable of choosing to act in a self-serving way. Given different circumstances and different self-states, we may choose to act differently at another time. We get into trouble when we try to define ourselves or others rigidly with one polarity to the complete exclusion of the other. In doing this, we restrict our range of possibility, and we actually empower the opposite polarity. So, the person who can only be saintly will be hounded by feelings and thoughts of the sinner. Or he may attempt to rid himself of those thoughts and impulses by projecting them onto others, where the other can be scorned, rejected, or persecuted. The attempt to separate one polarity from the other is doomed, and it leads to failure, imbalance, and a lack of wholeness. We all know narcissists who present to others and attempt to present to themselves an image of largeness, power, and significance. Those of us with some psychological awareness will also be aware that these people are plagued by...

Sequence of Contacting/Contact Continuum

One of the early contributions of Gestalt therapy theory was a phenomenological description of the sequence of contacting, from earliest arousal through action, through resolution. As with everything theoretical, there has been dispute and controversy regarding the details of this description. But I am less interested in the details of this formulation, and more interested in the frame that it gives us when looking at healthy behavior, and therefore at unhealthy behavior. Contact is the basic and essential experience of being aware of some element of the field (whether internal or external). It includes awareness of and behavior toward, and it is essential to consciousness, survival, and being human. So any awareness of some-thing is consciousness. And it is what allows us to be engaged with the world that is our de facto and life sustaining context. Contact tends to be organized around needs, whether the needs are biological, relational, intellectual, or whatever. We become aware of needs, whether through contact with a growling sensation in our stomach, which becomes hunger; or a pulsing sensation in our groin, which becomes lust; or a dryness in the mouth, which becomes thirst; or an open and whimsical feeling, which becomes playfulness, or… We start with a sensation that “catches” our awareness. This sensation, when noticed, becomes an expression of a need. So, dryness in the mouth and throat may be “figural”. But when we notice the dryness, it leads us to the need – so “thirst” becomes figural. And in noticing our thirst, we begin to “organize the field” around sources of quenching our thirst – so the bottle of water...

The Problem With Technique(s)

There has been a shift in the field of psychotherapy toward learning and using techniques – ways of using specific intervention styles, behaviors, or strategies in order to deal with specific symptomotology . This has become increasingly popular with therapists and insurance companies for some very practical reasons: they help to focus the intervention in relation to something very specific and therefore definable; they limit the involvement of complicating factors; they can be quantified and studied; they have effect. Given these factors, it is easy to see why insurance companies would encourage and even mandate these “evidence based strategies”, or techniques: the intervention can be brief(er) – and therefore less expensive – since the focus is very specific and doesn’t include a lot of complicating factors. Therapists can feel rewarded by the support of the insurance industry, as well as feeling a sense of “knowing” and mastery of their ability to heal their patients. These are very important factors for therapists, who need to be financially remunerated, and who also have a genuine desire to help their patients to be alleviated from the symptoms that plague them. So, if a patient is plagued by anxiety, the clinician can direct them to a “square breathing” technique, or to positive visualization, or to affirmations, or to tapping alternate sides of the body, etc, etc. If someone is living with the after effects of trauma, the clinician can utilize alternate tapping, cognitive re-framing, somatic release, etc, etc. There are approaches to therapy which have constructed workbooks (or “cookbooks”) to deal with various circumstances or symptoms, and market themselves for their structure and...

Comparing Basic Assumptions of Different Approaches to Psychotherapy

When we look at different approaches to psychotherapy, we are actually not looking at interchangeable strategies, techniques, or interventions. Each approach has its own set of theoretical, ethical, relational, and structural assumptions. And each set of assumptions leads to and even dictates the role of the therapist and the nature of the relationship between the therapist and the client. First, let’s look at the basic premise of some common approaches – Gestalt therapy, Psychoanalysis, Behavior therapy, Cognitive Behavioral therapy, and EMDR. We need to consider what is their way of looking at what people are, what their view of health is, and what their view of the nature of problems is: GT: Gestalt therapists see the field as constantly emergent, as are people. That means that people are not static, but are constantly developing, needing, responding. The Self is the purely emergent expression of the person/organism. But self and organism do not exist without an on-going contact with the field (the world around us). Problems come to exist when the fluid contact between the person and the “field” is interrupted in a chronic and unaware manner. PA: In classical psychoanalysis, people are seen as being a function of their past, and are determined by a history that they do not remember as they experienced it. Painful experiences and forbidden aspects of the person are repressed and exiled to the “unconscious” mind, where they control the person’s feelings and behavior. Symptoms and neurosis therefore result from excessive deposits in that repository. BT: Behavior therapy sees people as largely a complex set of stimulus/response circuits. Some are set improperly, and need...